Ask a doctor on the topic of Neurology

Inquiries muscle twitches

July 29, 2016 | 15,00 EUR | answered by Dr. med. Frauke Gehring

Hello Dr. Höllering,

I already wrote to you yesterday regarding the twitching in my right calf.

https://frag-einen.com/arzt/neurologie__nervenheilkunde/muskelzucken-in-der-rechten-wade-502689.html

Regarding my mental cinema, I have made an appointment with a psychiatrist.

However, I am currently very restless and anxious, so I wanted to inquire if ALS can really be ruled out based on medical judgment by just conducting a clinical examination (motor skills, strength, reflexes) without imaging tests.

As I mentioned, my calf has been twitching on the inside for 3.5 weeks, sometimes also on the outside, almost constantly. Sometimes the back of my thigh also twitches, or the outside of my foot. The last two nights I also had major sleep problems because of this.

I practice walking on my tiptoes and heels daily, do strength and agility exercises for my arms to test them. I know it sounds ridiculous... If I'm completely honest, I still have strength and no paralysis. No signs of deterioration either. I have never experienced the painful cramps often described with ALS.

Is there anything you can recommend to me? Honestly, magnesium doesn't really help anymore.

And regarding Benign Fasciculations: How common are they, as I find little information on them? Is it common for them to occur only in one body part and persist for a long time?

One last question: Could nerve damage caused by the disc herniation be the reason for the twitching (since it's not all in the L5/S1 area)?

Thank you in advance!

PS: It's a shame that your practice is so far away. I would have liked to have a doctor like you as my primary care physician. I have read many of your contributions.

Dr. med. Frauke Gehring

Hello again,

first of all, thank you for the nice compliment!

ALS can be ruled out by 99.99%, as you do not have any paralysis and your other results were also inconspicuous. Imaging is really unnecessary, especially since symptoms of ALS usually begin in the hands.

Since there are more fasciculations and fewer cramps, magnesium probably doesn't help much. More information here: http://www.gesundheits-fakten.de/muskelzucken-ursachen-und-gegenmittel/. I suggest Progressive Muscle Relaxation according to Jacobson.

The bulging disc causes muscular misalignment, which in turn can promote fasciculations. That's why muscle relaxation is important.

You don't hear much about it because they are mild discomforts that many people don't consider worth mentioning. However, they are not uncommon.

Sincerely, Dr. Höllering